1. Field of the Invention
The present invention relates to surgical instrumentation and more particularly to apparatus for laparoscopic or endoscopic surgery providing tool access and a replaceable irrigation pump cartridge.
2. Brief Description of the Prior Art
Laparoscopic and endoscopic surgical instruments are used to perform surgery without the need to make large incisions, the procedure therefore being generally much less invasive than conventional surgery. Such surgical instruments include a hollow probe through which are inserted items such as an endoscope or laparoscope, a clip applier, microscissors, forceps, an optical fiber connected to a laser source for hemostatic cutting or coagulation, a set of electrodes connected to a generator for electrocautery, lines for irrigation and evacuation, etc. Multiple incisions or punctures for multiple probes are often required when more than one of the above items must be inserted at the same time. Since it is preferable to have as few punctures as possible in a patient's body, probes that can handle more than one device are desirable. It is also desirable to have as many reusable parts as possible in order to minimize costs. Reusable parts need to be designed for efficient cleaning/sterilization, and disposable parts need to be easy to replace and economical/simple in structure.
Prior art instruments have not generally been designed to meet all of the above objectives. For example, U.S. Pat. No. 5,230,704 by Moberg et al. discloses a surgical instrument designed for the singular purpose of providing suction and irrigation with hand held controls and a replaceable cartridge. A limitation of this instrument is that the location of the cartridge does not allow access for inserting additional instruments.
U.S. Pat. No. 4,274,409 by Bush describes a pump with disposable dispensing tubes (22.1, 24.1), but their installation and removal appears complex, and internal connections would need to be sterilized in order to assure proper sanitation. Bush describes the apparatus for use in a dispensing device, and not for use with an endoscopic type of instrument. Use with an endoscope/laparoscopic type of instrument does not appear to be practical.
U.S. Pat. No. 5,395,312 by Desai shows two embodiments of a surgical instrument in FIGS. 8 and 9, wherein the improvements include a disposable pump cartridge. The device of FIG. 8 shows the cartridge in the handle, and in this case sterilization of the handle bore and the motor mechanism may be required. The device of FIG. 9 avoids this problem, but in both embodiments, the cartridge blocks access to the probe, thereby restricting its use. Another disadvantage of this device is the weight in the handle due to the motor, which tends to displace the probe if not held continuously by the surgeon.
U.S. Pat. No. 5,562,703 by Desai is an example of the need to insert as many tools as possible through one probe. FIG. 17 shows a single probe through which passes an endoscope, adjustable electrodes, and irrigation fluid. This disclosure does not address the problem of a sanitary pump, or the need for a handle to control the probe position.
None of the prior art systems/devices address and solve all of the problems noted above. It is therefore clear that a more optimum instrument is needed that provides a combination of low cost, economical replacement parts, access to insert a variety of tools, and position control all in a single system.